TRANSCRANIAL

MAGNETIC STIMULATION
DAN
PERIPHERAL MAGNETIC
STIMULATION

By Saputra Aji Hasmana

TMS adalah suatu tindakan metode invasive
untuk mensetimulasi otak dengan
menggunakan gelombang electromagnetic
yang diinduksikan melalui koil yang diletakan
diatas kepala

• STIMULASI
• INHIBISI
Transcranial magnetic stimulation (TMS)

bekerja berdasarkan prinsip elektromagnet.

Kumparan yang dialiri arus listrik bisa
menginduksi arus pada sikruit lain di
sekitarnya. Karena itu, secara teori kumparan
yang diletakkan di atas kulit kepala dan dialiri
arus listrik akan bisa menginduksi jaringan
kortikal. Arus listrik dengan frekuensi tinggi
(> 5 Hz) menginduksi efek eksitatorik pada
jaringan kortikal dan frekuensi rendah (< 1 Hz)
menginduksi efek inhibitorik
 Paired-pulse threshold tracking transcranial magnetic stimulation (TMS). (A) TMS coil placed over the vertex
activates the primary motor cortex and the response (motor evoked potential, MEP) is recorded from the
contralateral abductor pollicis brevis muscle. (B) TMS parameters are mediated by a complex interplay between
intraneural circuits and cortical output cells, with cortical interneurons mediating inhibition by activation of
GABAergic synapses leading to influx of chloride anions (Cl − ) and hyperpolarization of post-synaptic neurons.
(C) Change in stimulus intensity required to achieve a target MEP of 0.2 mV (±20%) is used to quantify SICI
(which is recorded with interstimulus intervals between 1-7 ms) and ICF (between 10-30 ms).
 PMS (PERIPHERAL MAGNETIK STIMULATION)
Metode non invasive untuk mengurangi nyeri
dengan menggunakan gelombang elektromagnetik
yang dialirkan melalui koil yang diletakan di
permukaan tubuh

• Inhibisi nyeri
• Blokir nyeri
Stimulation by repetitive peripheral
magnetic stimulation (rPMS). A figure-of-
eight stimulation coil was used for rPMS,
which was applied either to the mTrPs of
the trapezius muscles (trapezius group) or
to the mTrPs of the deltoid muscles (deltoid
group) in the context of six stimulation
sessions. Direct contact between the skin
and the coil surface was ensured
throughout, and the coil position was fixed
by a static coil holder. In subjects of the
trapezius group, the coil was centered and
fixed above the previously identified mTrPs
of the upper trapezius muscles
perpendicularly to the anatomical course